| NPI | 1295306140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020350) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 63568) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2022-03-11 |