| NPI | 1003926015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OH RN 186354) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OH NS-04758) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |