| NPI | 1184297624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRNCNP0030384) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH RN.455460) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: OH LE-00039231) | |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-12-07 |