| NPI | 1730157595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.004185-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO RN-165502) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-10-23 |