| NPI | 1437440021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA-12372) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN325802) |
| 163W00000X Registered Nurse (Licence: PA RN597631) | |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2011-06-21 |