| NPI | 1548531973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 202009567CRNA-PP) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60436137) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2022-07-27 |