| NPI | 1023059938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN280986) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN632594) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2023-08-28 |