| NPI | 1285463414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021282) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.465501) |
| Enumeration Date | 2024-07-27 |
| Last Update Date | 2025-06-25 |