| NPI | 1033248158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30007722) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200260040) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-08-08 |