| NPI | 1205721040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN546951) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OH RN546951) |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OH RN546951) | |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-06-11 |