| NPI | 1801887740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.07136) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH NA07136) |
| 207L00000X Anesthesiology (Licence: OH RN302998) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2024-06-11 |