| NPI | 1558879791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019632) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH LE-00022018) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-25 |