| NPI | 1326148859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61349295) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R26145) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2024-03-18 |