| NPI | 1275855751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN356256) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: OH RN356256) |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2010-02-24 |