| NPI | 1386103695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 463911) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: NC 292204) |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2019-07-22 |