| NPI | 1326131814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 1409A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28086314) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3001409) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.12279-NA) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-12-05 |