| NPI | 1346840535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: OH RN261645) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: OH RN261645) |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: OH RN261645) | |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |