| NPI | 1053887539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7150) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019788) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH 396641) | |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2023-08-04 |