| NPI | 1326877523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021510) |
| Additional Taxonomies | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: OH RN.477379) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2026-07-08 |