| NPI | 1336745942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020221) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.44573) |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2021-02-11 |