| NPI | 1598733818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN316539L) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN308280COA1) |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2014-10-22 |