| NPI | 1497757314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN 254416 NA-06872) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN174836 CRNA) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2008-12-29 |