| NPI | 1386802650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN311893) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 311893) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN593061) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA10696NA) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2019-02-13 |