| NPI | 1215789896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021049) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.425392) |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-11-14 |