| NPI | 1225275126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0015014-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 156632-3) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO CRA-15014) | |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2024-12-05 |