| NPI | 1316302946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 24598) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN 391011) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA 18540-NA) | |
| Enumeration Date | 2015-12-26 |
| Last Update Date | 2021-11-10 |