| NPI | 1114587136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: OH F02190617) |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: OH F02190617) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2023-01-26 |