| NPI | 1225071483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60401882) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60401880) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-06-26 |