| NPI | 1255721098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101560) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN.346509-COA1) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2020-10-07 |