| NPI | 1588001002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61127922) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: WA RN60090427) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2022-01-19 |