| NPI | 1861073017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.0028752) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH APRN.CNP.0028752) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-06-11 |