| NPI | 1891157525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60651681) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60406797) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-06-06 |