| NPI | 1487629259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30004341) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 000000000000) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2021-05-18 |