| NPI | 1306861901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11001417) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN216636) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-216636) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-03-04 |