| NPI | 1548866791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: OH 434436) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OH 434436) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2020-12-11 |