| NPI | 1386950418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: NC 5009794) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OH coa07506np) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2021-03-30 |