| NPI | 1679711345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1019213) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019328) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2022-07-20 |