| NPI | 1851310742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO SRA-25014) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 192489) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: NC 192489) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 192489) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-06-10 |