NPI | 1194034553 |
---|---|
Former Name | BRENNON E GILES |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.11807) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 11807) |
Enumeration Date | 2010-10-04 |
Last Update Date | 2024-08-02 |