| NPI | 1821318502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60162499) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MT 202817) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2022-11-30 |