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 |