| NPI | 1942392006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA- 09169) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN 329611) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2018-05-31 |