| NPI | 1316281892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 202202717CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA RN60157271) |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2022-07-05 |