| NPI | 1295915759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28188327A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28188327A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 287009) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH CERT #78435) | |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2022-12-20 |