| NPI | 1013932425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202002489CNS-PP) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: OR 202002489CNS-PP) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NC 163552) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201501835NP-PP) | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: OR 201501835NP-PP) | |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: OR 202002489CNS-PP) | |
| 364SP0811X Clinical Nurse Specialist, Psych/Mental Health, Chronically Ill (Licence: OR 201501835NP-PP) | |
| 364SP0813X Clinical Nurse Specialist, Psych/Mental Health, Geropsychiatric (Licence: OR 202002489CNS-PP) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-12-20 |