| NPI | 1538313507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO CRA-5972) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 166822) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2013-08-15 |