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Individual provider · Certified Registered Nurse Anesthetist · Sedalia, MO

NPI

1396129722

Type

Individual (Type 1)

Primary specialty

Certified Registered Nurse Anesthetist (Nurse Anesthetist, Certified Registered)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

367500000X

License number

2015023437 (MO)

Sex

Male

Sole proprietor

No

Enumerated

2015-07-15

Last updated

2015-07-15