NPI | 1003298423 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: TX AP129633) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 783012) |
Enumeration Date | 2015-06-22 |
Last Update Date | 2020-11-10 |