NPI | 1093345076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0031807) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP144563) |
363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0031807) | |
Enumeration Date | 2020-01-18 |
Last Update Date | 2024-07-03 |