| NPI | 1013249952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 11521NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.308679) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-07-12 |