| NPI | 1104290998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0992216-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO RN.0194478) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2024-10-08 |