| NPI | 1982682464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000326) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH CRNA08492NA) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2008-04-30 |