| NPI | 1316395759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5427) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0004324-C-CRNA) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2025-02-12 |