| NPI | 1154711497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.16984) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 16984-NA) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2021-04-05 |