| NPI | 1184498685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 163WG0000X Registered Nurse General Practice (Licence: OH RN.423506) |
| Additional Taxonomies | 163WA2000X Registered Nurse Administrator (Licence: OH RN.423506) |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: OH RN.423506) | |
| 163WC1500X Registered Nurse Community Health (Licence: OH RN.423506) | |
| 163WE0003X Registered Nurse Emergency (Licence: OH RN.423506) | |
| 315P00000X Intermediate Care Facility, Mentally Retarded | |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2024-06-19 |