| NPI | 1386136166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60892904) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WA RN60113179) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2019-10-17 |