| NPI | 1679571400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN 145207) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704240687) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN555078) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 162979) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2012-08-26 |