| NPI | 1245538271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO CRA-100031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN-172125) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-06-28 |