| NPI | 1689515397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 0021617) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.459454) |
| Enumeration Date | 2026-04-06 |
| Last Update Date | 2026-07-06 |