| NPI | 1730170762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 054909) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28167897A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 054909) | |
| 163W00000X Registered Nurse (Licence: KY 115268) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 5418a) | |
| 163W00000X Registered Nurse (Licence: OH 265285) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2013-06-05 |