| NPI | 1013964089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.03168) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH KN237880) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2022-07-19 |