| NPI | 1285034371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60512045) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA RN00169498) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2021-04-14 |