| NPI | 1710922653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30006244) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID N-32474) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2014-03-06 |