NPI | 1063787836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60499120) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201142666RN) |
Enumeration Date | 2012-03-13 |
Last Update Date | 2022-04-01 |