| NPI | 1295368488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.026342) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH APRN.CNP.026342) |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |