| NPI | 1366439879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA-07829) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 368) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2010-10-21 |