| NPI | 1568868404 |
|---|---|
| Former Name | WENDELL WESLEY SYRUS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 17197-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704312544) |
| 163W00000X Registered Nurse (Licence: OH RN307520) | |
| 163W00000X Registered Nurse (Licence: MI 4704312544) | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2024-03-20 |