| NPI | 1124466495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61017573) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DC RN1020645) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-07-23 |