| NPI | 1093373458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61320756) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60309732) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA21366) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA 60309732) | |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2024-04-30 |