| NPI | 1497337463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020316) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH rn.396668) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2021-07-29 |