NPI | 1023885514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.0037144) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.464170) |
Enumeration Date | 2023-12-05 |
Last Update Date | 2024-07-25 |