| NPI | 1700239423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019304) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.175033) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OH RN.358502) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2024-02-28 |