NPI | 1326684168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 026331) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH 405558) |
Enumeration Date | 2019-11-26 |
Last Update Date | 2020-02-19 |