| NPI | 1154974129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 202003523CRNA) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WA 60850422) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61004259) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2025-12-23 |