NPI | 1922594167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.023101) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.023101) |
363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.023101) | |
Enumeration Date | 2018-07-10 |
Last Update Date | 2023-11-07 |