| NPI | 1730503624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.15687) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 93621) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2024-08-06 |