NPI | 1801461793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: OH APRN.CNP.0029344) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0029344) |
363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OH APRN.CNP.0029344) | |
Enumeration Date | 2021-05-24 |
Last Update Date | 2025-07-14 |