| NPI | 1801671292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0999242-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1636172) |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-10-24 |