| NPI | 1578958740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: SC 218962) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OH RN.370048-) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2015-04-03 |