NPI | 1912375882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: OH APRN.CNP.17946) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.17946) |
Enumeration Date | 2015-09-09 |
Last Update Date | 2024-11-19 |