| NPI | 1932351251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60065611) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00121810) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2018-10-18 |