| NPI | 1053667337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: OH APRN.CNP.13704) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.13704) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2026-08-07 |