NPI | 1386361236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.0032934) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.0032934) |
163W00000X Registered Nurse (Licence: OH RN.451691) | |
Enumeration Date | 2022-10-21 |
Last Update Date | 2024-10-12 |