| NPI | 1831233691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.268494) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 028918) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |