| NPI | 1306895040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN-233546) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| 163W00000X Registered Nurse (Licence: OH RN-233546) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2025-04-02 |