| NPI | 1356694244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60616023) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9236268) |
| 163W00000X Registered Nurse (Licence: MA 2282711) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 2282711) | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2023-10-25 |