| NPI | 1053981217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020424) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 415501) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2022-01-13 |