| NPI | 1245753821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019538) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN360628) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2023-11-06 |