NPI | 1164191342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: OH 473776) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OH 473776) |
Enumeration Date | 2021-09-10 |
Last Update Date | 2021-09-10 |