| NPI | 1609001056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60100240) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00132710) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2019-11-21 |