| NPI | 1467437772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.00847-NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.166462-COA1) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2017-06-05 |