| NPI | 1699496232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61358400) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60291585) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2022-09-19 |