| NPI | 1811981764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA ap300005237) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 085073617CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30005237) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2024-06-10 |