| NPI | 1710627971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020597) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH PENDING) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2023-11-03 |