| NPI | 1134730088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61468260) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OR 202003418RN) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2024-04-19 |