| NPI | 1679873061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH rn236325) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH rn236325) |
| 163WF0300X Registered Nurse, Flight (Licence: OH rn236325) | |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2010-11-01 |