| NPI | 1598067209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 2269181) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRNCRNA15246) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2023-03-24 |