| NPI | 1811616022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH 0032364) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH 407729) |
| 208M00000X Hospitalist (Licence: OH 0032364) | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2025-08-28 |