| NPI | 1508334269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 124373) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN381542) |
| Enumeration Date | 2018-11-10 |
| Last Update Date | 2021-04-07 |