| NPI | 1285463463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021299) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH 505512) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2025-05-22 |