| NPI | 1376545202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-150955) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 150955) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2010-09-28 |