NPI | 1013392141 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201140102RN) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201140102RN) |
Enumeration Date | 2015-07-30 |
Last Update Date | 2016-01-22 |