| NPI | 1962582320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.005860-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 187940) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2018-10-17 |