| NPI | 1194283721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 025098) |
| Additional Taxonomies | 163WF0300X Registered Nurse, Flight (Licence: OH RN.365577) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.025098) | |
| Enumeration Date | 2019-03-02 |
| Last Update Date | 2019-07-22 |