NPI | 1235774399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020617) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704315948) |
Enumeration Date | 2019-11-13 |
Last Update Date | 2023-11-03 |