| NPI | 1851541452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OH COA.10267-NP) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: OH COA-10267-NP) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2019-01-22 |