| NPI | 1376510438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30004693) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00125030) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2019-07-10 |