| NPI | 1376682336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO CRA-5950) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 163213) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-06-06 |