| NPI | 1235700352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020643) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704312992) |
| 163W00000X Registered Nurse (Licence: OH 468355) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704312992) | |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2022-10-24 |