| NPI | 1770028649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN CRNA 019381) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 019381) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2017-05-31 |