NPI | 1720852650 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0035730) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.478554) |
Enumeration Date | 2023-11-10 |
Last Update Date | 2024-12-16 |