| NPI | 1356852164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA Ap60807265) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: WA Rn00168846) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2018-06-10 |