| NPI | 1295038651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA-12097) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN-325287) |
| 163W00000X Registered Nurse (Licence: PA RN-618463) | |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2011-01-11 |