| NPI | 1508019951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: OH NP 03833) |
| Additional Taxonomies | 163WN0002X Registered Nurse Neonatal Intensive Care (Licence: OH RN187213) |
| 163WN0002X Registered Nurse Neonatal Intensive Care (Licence: OH NP-03833) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2008-10-29 |