| NPI | 1275800641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020295) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704261256) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4704261256) | |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2021-12-30 |