Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | COA. 14818-NP | OH |
NPI | 1043643174 |
---|---|
Provider Name | Patrick M. Hoferer |
First Address | Cincinnati, OH 45248-1691 |
Second Address | Cincinnati, OH 45248-1691 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2013 |
Last Update Date | 13/08/2013 |