| NPI | 1447941646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: WV 116447) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: WV 116447) |
| 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0033854) | |
| 363L00000X Nurse Practitioner (Licence: WV 116447) | |
| 363LA2100X Nurse Practitioner Acute Care (Licence: OH APRN.CNP.0033854) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: OH APRN.CNP.0033854) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: OH APRN.CNP.0033854) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: WV 116447) | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2024-05-07 |