| NPI | 1780670729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 118337) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN 313609 / NA-07927) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2017-02-08 |