| NPI | 1780101360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019542) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 118169) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-09-05 |