| NPI | 1881010445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 317943) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 321769) |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2020-03-03 |