NPI | 1013353523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201242380RN) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201242380RN) |
Enumeration Date | 2013-05-13 |
Last Update Date | 2013-09-03 |