| NPI | 1861406456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: OH APRN.CNP.08037) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN203695) |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: OH RN203695) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-05-17 |