| NPI | 1073916433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.17043) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.17043) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.17043) | |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: OH APRN.CNP.17043) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH APRN.CNP.17043) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: OH 133153) | |
| 163WF0300X Registered Nurse, Flight (Licence: OH 345531) | |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2025-08-21 |