| NPI | 1497010565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRNCRNA13115) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH RN.333061) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2017-04-03 |