| NPI | 1245271352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60822574) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: HI 52491) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-09-04 |