| NPI | 1821617903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH aprn.cnp.026538) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH aprn.cnp.02538) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2023-11-03 |