| NPI | 1720132343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 76225) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP30005884) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30005884) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-10-30 |