| NPI | 1104229210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: OH APRN.CNP.16478) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OH APRN.CNP.16478) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2025-04-25 |