| NPI | 1023442324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60633491) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WA RN00175697) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2024-01-23 |