| NPI | 1407939796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019367) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9281942) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-08-30 |