| NPI | 1386058386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60500709) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60063340) |
| 163W00000X Registered Nurse (Licence: OR RN200743638) | |
| 163W00000X Registered Nurse (Licence: AZ RN13946) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-05-12 |