| NPI | 1427632454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0996896-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1672852) |
| 163W00000X Registered Nurse (Licence: OH RN.417865) | |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2025-11-06 |