| NPI | 1700592318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.1001529-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1668511) |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2026-02-05 |