| NPI | 1043882202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 0020463) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.431149) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2022-06-30 |