NPI | 1821595059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.022957) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.022957) |
Enumeration Date | 2018-04-13 |
Last Update Date | 2018-08-23 |