| NPI | 1134299803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: OH RN.212501) |
| Additional Taxonomies | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: OH RN-212501) |
| 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: OH RX-NS-05136) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2018-01-30 |