| NPI | 1902412133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: OH APRN.CNP.0027474) |
| Additional Taxonomies | 163WN0002X Registered Nurse Neonatal Intensive Care (Licence: OH RN.434488) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |