| NPI | 1760735054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.14120-NA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1106897) |
| 163W00000X Registered Nurse (Licence: OH RN.364101) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11011916) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2024-11-14 |