| NPI | 1952671885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 20204) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN321481) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA 13085 NA) | |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2025-01-17 |