| NPI | 1730513342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN356025-1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 265331) |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2016-02-08 |