| NPI | 1659702033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0001193) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 751038) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2023-07-23 |