| NPI | 1518474949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 019594) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH LE-00021940) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2021-10-26 |