| NPI | 1982027645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CNP.15541) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN.370150-COA1) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2023-11-03 |