| NPI | 1548709215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704285138) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0000009) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2021-12-16 |