| NPI | 1982234290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.388939) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OH RN.388939) |
| 163WG0000X Registered Nurse, General Practice (Licence: OH RN.388939) | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2020-01-26 |
| Last Update Date | 2021-07-08 |