| NPI | 1447505250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60344576) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4261) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2018-01-22 |