| NPI | 1144749482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.021665) |
| Additional Taxonomies | 163WN0800X Registered Nurse, Neuroscience (Licence: OH APRN.CNP.021665) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2023-02-17 |