| NPI | 1982051983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRNCRNA019325) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN382625) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2018-10-23 |