| NPI | 1154377331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA-01763) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN-114377331) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2011-03-23 |