| NPI | 1467786251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.11014) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 306607) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2019-11-25 |