| NPI | 1831361062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020314) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 147108) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2021-07-01 |