| NPI | 1710422530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0993051-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.020220004) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2018-01-22 |