| NPI | 1871423954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA ARNP.AP.70143248) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001327001) |
| Enumeration Date | 2026-05-21 |
| Last Update Date | 2026-06-30 |