| NPI | 1427323682 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9266438) | 
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRNCRNA019691) | 
| Enumeration Date | 2012-03-20 | 
| Last Update Date | 2023-03-24 |