NPI | 1639154685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 023081) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1028649) |
163W00000X Registered Nurse (Licence: OH 154045) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA00804) | |
Enumeration Date | 2005-12-13 |
Last Update Date | 2016-09-16 |