| NPI | 1467450312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 054905) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 269834) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28216927A) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2018-11-07 |