| NPI | 1437490638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA 14410-NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN 338558) |
| 163W00000X Registered Nurse (Licence: FL 9309052) | |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2015-05-20 |