| NPI | 1801209143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: OH APRN.CNS.15989) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: OH RN.352635) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2018-08-13 |