| NPI | 1457014862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0101671-C-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 212385) |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2024-02-18 |