NPI | 1649588575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.429968) |
Additional Taxonomies | 405300000X Prevention Professional (Licence: OH 429968) |
Enumeration Date | 2010-09-14 |
Last Update Date | 2024-07-29 |