NPI | 1528726726 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 0027891) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH 0027891) |
Enumeration Date | 2021-12-04 |
Last Update Date | 2021-12-04 |