| NPI | 1568085488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH APRN.CNP.0027167) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0027167) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH RN.425310) | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2023-11-03 |