| NPI | 1083951974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.14452) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 91367) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2023-05-25 |