| NPI | 1679545826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN263402-COA1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN346674L) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2015-06-23 |