| NPI | 1225669690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH APRN.CNP026716) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH RN.388552) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2023-09-18 |