| NPI | 1467440651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO CRA-452) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 97809) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP1276112) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2013-04-17 |