| NPI | 1396417838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.0030039) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.383930) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.0030039) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.0030039) | |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2022-01-10 |