| NPI | 1205386018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.019474) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2024-03-15 |