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 |