NPI | 1053806786 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60790046) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 60790046) |
Enumeration Date | 2018-06-25 |
Last Update Date | 2019-09-03 |