| NPI | 1962074252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 136750) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: OH RN.403093) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2022-01-03 |