NPI | 1013456060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60733956) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60132341) |
Enumeration Date | 2017-02-22 |
Last Update Date | 2022-07-21 |