| NPI | 1942411848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60800275) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OR 200440093rn) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201160007CRNA) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 63699) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-11-18 |