| NPI | 1427020684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 226058) |
| Additional Taxonomies | 163WX0002X Registered Nurse, Obstetric, High-Risk (Licence: WA AP30006802) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30003802) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2020-06-23 |