| NPI | 1255160446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021316) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.462625) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2025-06-12 |