| NPI | 1558878470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 007608) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019626) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 118034) | |
| Enumeration Date | 2017-12-30 |
| Last Update Date | 2025-02-07 |