| NPI | 1780992818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN320169) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 320169) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2011-04-12 |