NPI | 1407203482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.022658) |
Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OH MA4767680) |
163WC1500X Registered Nurse, Community Health (Licence: OH RN.397389-) | |
364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: OH APRN.CNP.022658) | |
Enumeration Date | 2016-05-19 |
Last Update Date | 2023-08-07 |