| NPI | 1518270438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.14227-NA) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.11611-NP) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2013-01-17 |