| NPI | 1992368245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019913) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH 377658) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-06-28 |