| NPI | 1932452182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0991732-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.13990) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2023-04-17 |