| NPI | 1457680241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 083848) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60273594) | |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2014-01-06 |