| NPI | 1952732471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: NC 282588) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OH 15442) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2021-03-31 |