| NPI | 1477270528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 0021272) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 447901) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2025-06-10 |