| NPI | 1598589939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021183) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 241534) |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2025-03-07 |