| NPI | 1588861371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-696A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA IT40000981) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2018-03-27 |