| NPI | 1295023331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60911360) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01527) |
| 101Y00000X Counselor | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2020-12-03 |