| NPI | 1568800795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0992188-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN342168) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA 15181 NA) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2025-07-01 |