| NPI | 1124608591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0996899-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1627576) |
| Enumeration Date | 2021-04-10 |
| Last Update Date | 2024-09-30 |