| NPI | 1194000588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.13120) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.334153) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2018-10-23 |