| NPI | 1598499600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.0031792) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH aprn.cnp.0031792) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2025-09-02 |