| NPI | 1699026716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60465497) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 5494384-3102) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2014-07-28 |