| NPI | 1972592244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.07374-NA) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH RN245631) |
| 207L00000X Anesthesiology (Licence: OH NA07374) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2009-07-01 |