| NPI | 1649063827 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH RN.478064) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2025-05-28 | 
| Last Update Date | 2025-05-29 |