| NPI | 1689336539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020456) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH RN.461010) |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2023-02-08 |