| NPI | 1326326083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61238629) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 774156) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4191) | |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2025-05-07 |