| NPI | 1760252498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61528422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61507707) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 145682) | |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-02-15 |