| NPI | 1962642751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60068032) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 81488) |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2023-02-09 |