| NPI | 1326088634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 029000) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 117984) |
| 207L00000X Anesthesiology (Licence: OH NA029000) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-02-04 |