NPI | 1053022558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH 294007) |
Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: OH 294007) |
Enumeration Date | 2022-12-06 |
Last Update Date | 2022-12-06 |