| NPI | 1609419670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN.403101) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 274390) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001849) | |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2024-08-13 |