| NPI | 1992402960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 143038) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 452066) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 143038) | |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2023-05-22 |