| NPI | 1982890406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D121054) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 078014) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2009-05-15 |