| NPI | 1851760961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024175954) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60870147) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2024-04-26 |