| NPI | 1699746305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200660047crna) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA na2781) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60620388) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-01-07 |