| NPI | 1407293699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0990803-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.0165348) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2023-11-27 |