| NPI | 1851599070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.09311) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH COA.09311-NP) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2023-07-25 |