| NPI | 1447522503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60561124) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95001781) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2023-10-12 |