| NPI | 1104547934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH 381510) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH 381510) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2022-09-09 |