| NPI | 1730566852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61178526) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000378) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2023-04-18 |