| NPI | 1265733745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.12043-NA) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: OH 363992) |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2022-01-25 |