| NPI | 1659898211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019559) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.345017) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2018-03-05 |