| NPI | 1992793228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 00821-NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN 185521-COA-1) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2023-01-12 |