| NPI | 1457587917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0991696-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 68285) |
| 163W00000X Registered Nurse (Licence: CO RN.0166686) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101094) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2017-02-14 |