| NPI | 1346897303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0003798-C-CRNA) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR R101414) |
| 207L00000X Anesthesiology (Licence: AR 216892) | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2023-06-15 |