| NPI | 1396017760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.13131-NA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA13131) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2025-09-15 |