| NPI | 1942005673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558299-082) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: KS 13-147046-082) |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-06-19 |