| NPI | 1982680658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-169856) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA-01538) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2007-07-08 |