| NPI | 1982890638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO RN.0200283) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0100072-CRNA) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2025-01-02 |