| NPI | 1922244557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60214919) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200842087RN) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA N360215716) | |
| 163W00000X Registered Nurse (Licence: WA RN00130734) | |
| Enumeration Date | 2009-01-03 |
| Last Update Date | 2011-04-21 |