| NPI | 1083184725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.024001) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH F09181760) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.024001) | |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2024-02-22 |