| NPI | 1891342085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: OH APRN.CNP.025093) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.025093) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2021-01-18 |