| NPI | 1073892451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0100982-C-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-110132) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9283645) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 21165) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2023-12-14 |