| NPI | 1356696686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019526) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 579493) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2024-01-18 |