| NPI | 1265702450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: OH APRN.CNS.12993) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.335975) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2019-11-15 |