| NPI | 1396140836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.16962-NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.308021) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2017-05-26 |