| NPI | 1558065540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0100839-C-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.417689) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-05-23 |