| NPI | 1780283739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 0020268) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN.403927) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2021-03-23 |