| NPI | 1336124494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN.164877-COA1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28143161A) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2018-03-17 |