NPI | 1720191406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30004854) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00123757) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2015-03-23 |