NPI | 1760070007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95034966) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0029433) |
163W00000X Registered Nurse (Licence: OH RN.466018) | |
163W00000X Registered Nurse (Licence: CA 95415323) | |
Enumeration Date | 2021-01-04 |
Last Update Date | 2025-09-11 |