| NPI | 1922580877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60905092) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60800197) |
| 163W00000X Registered Nurse (Licence: NV RN93861) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 823106) | |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2019-08-26 |