NPI | 1487228144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.454635) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2021-05-18 |
Last Update Date | 2021-07-06 |