| NPI | 1003704214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH 495498) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OH 495498) |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |