NPI | 1134464951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 020782) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 387037) |
Enumeration Date | 2012-12-05 |
Last Update Date | 2022-03-21 |