| NPI | 1124178942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 4542) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 157760) |
| 163W00000X Registered Nurse (Licence: OH 340936) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 075309) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 10054) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-05-13 |