NPI | 1902250277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.019311) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.019311) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2020-06-10 |