| NPI | 1841688140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61203211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 780609) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2023-05-02 |