| NPI | 1841313780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60117220) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 194120) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 194120) | |
| 163W00000X Registered Nurse (Licence: WA RN00128073) | |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2012-12-13 |