| NPI | 1992294953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.023341) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CO 1635710) |
| Enumeration Date | 2018-05-05 |
| Last Update Date | 2019-07-11 |