NPI | 1861731879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60338800) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60326140) |
Enumeration Date | 2013-02-11 |
Last Update Date | 2023-06-13 |