| NPI | 1558439166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 60559159) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 054252) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2019-03-13 |