| NPI | 1518992858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30007782) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 7725758) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-11-18 |