| NPI | 1609837962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0600X Registered Nurse, Gerontology (Licence: OH RN 278713) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: OH RN 278713) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2007-07-09 |