| NPI | 1093928236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60863426) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00033804) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-04-21 |