| NPI | 1497337463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 314258) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020316) |
| 163W00000X Registered Nurse (Licence: OH rn.396668) | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2025-01-13 |