| NPI | 1669081766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61468049) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OR 202006466rn) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2023-07-27 |