| NPI | 1154765725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28174942A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 35.1362) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2022-12-29 |