| NPI | 1699002741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0990610-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1617308) |
| 163W00000X Registered Nurse (Licence: OH RN.301607) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN301607) | |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2021-08-31 |