| NPI | 1316223050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0000393-C-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ND R34540) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 186244-30) | |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2015-10-06 |