| NPI | 1477876688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020658) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D147553) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 83709) | |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2022-11-01 |