| NPI | 1639547540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 360873-1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.18093) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2024-07-29 |