| NPI | 1487841102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 1099) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CO RN.0184713) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2023-06-01 |