| NPI | 1184002461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60577142) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00146171) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-06-24 |