NPI | 1215696737 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH APRNCNP0039284) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP024705) |
Enumeration Date | 2021-12-13 |
Last Update Date | 2025-08-25 |