| NPI | 1407310444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH LE-00027185) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 382644) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-29 |