| NPI | 1780767079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0101244-C-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN124353) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-01-05 |