| NPI | 1902857337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60025710) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 071445) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-11-24 |