| NPI | 1235434929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 244604) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.351247-) |
| 163W00000X Registered Nurse (Licence: VA 0001207748) | |
| 163W00000X Registered Nurse (Licence: NC 244604) | |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2016-08-11 |