NPI | 1477250363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH 0033872) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704394426) |
163W00000X Registered Nurse (Licence: OH 401688) | |
363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704394426) | |
Enumeration Date | 2023-02-10 |
Last Update Date | 2023-06-02 |