| NPI | 1255517181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0003556-C-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 077961) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1227) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2023-01-19 |