| NPI | 1881687705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28200961) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-240448) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2012-08-28 |