| NPI | 1639605819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH APRN.CNP.021792) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: OH APRN.CNP.021792) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2021-07-09 |