| NPI | 1194706366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA 08045) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 272372) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2008-02-25 |