| NPI | 1982271532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704293064) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.456957) |
| 163W00000X Registered Nurse (Licence: MI 4704293064) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 0020358) | |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2023-08-21 |