| NPI | 1164424909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.08358) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.319483) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 100355) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2018-10-23 |