| NPI | 1487602769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-256368) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 157695) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2018-02-13 |