NPI | 1841548864 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH COA 13752 NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 327336) |
Enumeration Date | 2012-08-23 |
Last Update Date | 2013-12-02 |