| NPI | 1922533009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28280811A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRNCRNA019502) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2023-05-03 |