| NPI | 1922432970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60634596) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201391621RN) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2016-02-08 |