| NPI | 1013957869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA00404NA-) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 186563) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704162404) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2018-07-21 |