| NPI | 1932554078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.19256) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN342686) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2018-09-07 |