NPI | 1316938509 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH RN 190418) |
Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: OH RN 190418) |
Enumeration Date | 2005-11-04 |
Last Update Date | 2007-07-08 |