| NPI | 1235597881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 430661) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9365168) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 1129006) | |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2019-04-02 |