NPI | 1033980511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0036839) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.518828) |
Enumeration Date | 2024-01-12 |
Last Update Date | 2024-07-10 |