| NPI | 1760890438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: OH RN 303216) |
| Additional Taxonomies | 163WI0500X Registered Nurse Infusion Therapy (Licence: OH RN 303216) |
| 163WX0800X Registered Nurse Orthopedic (Licence: OH RN 303216) | |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2014-07-25 |