| NPI | 1568823987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRNCRNA19190) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 223111) |
| Enumeration Date | 2016-03-12 |
| Last Update Date | 2023-11-03 |