| NPI | 1013674498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61270717) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA ap61270717) |
| Enumeration Date | 2021-11-20 |
| Last Update Date | 2023-03-08 |