| NPI | 1053363622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH Rn280092) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0102401-C-CRNA) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2026-05-06 |