| NPI | 1063465706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRNCRNA13371) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 1268) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-04-02 |