| NPI | 1467690008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60188572) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 156012-030) |
| 163W00000X Registered Nurse (Licence: MN R175492-8) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WA RN00140081) | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2011-01-21 |