| NPI | 1598792186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60056924) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200860027CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-530) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-12-11 |