| NPI | 1780095380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60479742) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA RN00171218) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2021-04-19 |