| NPI | 1659316123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.06849-NA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA06849) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2021-12-15 |