| NPI | 1528730702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH APRN.CNP.0089930) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH RN.396617) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2023-11-03 |