| NPI | 1023013547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH APRN.CRNA.07130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH RN-279168) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.07130-NA) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2019-09-26 |