| NPI | 1891984241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60832758) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 531238) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3671) | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2020-12-09 |