| NPI | 1992188742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.17539) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.17539) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.17539) | |
| 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: OH APRN.CNS.019319) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2024-07-03 |