| NPI | 1770030686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60695727) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N43868) |
| 163W00000X Registered Nurse (Licence: AZ RN199298) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1237) | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-13 |