NPI | 1114980794 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30004706) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00130544) |
Enumeration Date | 2006-04-06 |
Last Update Date | 2009-10-07 |