| NPI | 1134482029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.13948-NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.320250-COA1) |
| Enumeration Date | 2012-06-17 |
| Last Update Date | 2012-10-17 |