| NPI | 1205860913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 058522-23) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH RN-313611) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-313611) | |
| 163W00000X Registered Nurse (Licence: NH 058522-21) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-03-17 |