| NPI | 1902182777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.13115-NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.333950) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2012-02-24 |