| NPI | 1215248661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent (Licence: OH 268052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 268052) |
| 163WC1400X Registered Nurse College Health (Licence: OH 268052) | |
| 163WG0600X Registered Nurse Gerontology (Licence: OH 268052) | |
| 163WP0200X Registered Nurse Pediatrics (Licence: OH 268052) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: OH 268052) | |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: OH 268052) | |
| 163WX0800X Registered Nurse Orthopedic (Licence: OH 268052) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |