| NPI | 1821671777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 0020368) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OH 427680) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-11-02 |