| NPI | 1396926465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704185386) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH ARPN.CRNA019781) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2018-11-16 |