| NPI | 1285771634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019935) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 667489) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 178376-030) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.008888) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2019-09-11 |