NPI | 1134613201 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NP95016249) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.022953) |
363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.022953) | |
363L00000X Nurse Practitioner (Licence: OH APRN.CNP.022953) | |
Enumeration Date | 2018-06-21 |
Last Update Date | 2023-01-20 |