| NPI | 1285947499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.11518) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.319338) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2019-09-13 |