NPI | 1578303392 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0036418) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.436264) |
363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.0036418) | |
Enumeration Date | 2024-05-29 |
Last Update Date | 2024-05-29 |