| NPI | 1447832787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 0028634) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4018982) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP030965) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71015771A) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-10-21 |