| 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 |