| NPI | 1326830043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61682957) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: WA AP61682957) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-26 |