| NPI | 1295923019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA 09678 NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN 301207 COA1) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2015-05-20 |