| NPI | 1497088645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN262499) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 58256) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2020-11-30 |