NPI | 1033492954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5005303) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005303) |
364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: NC 5005303) | |
Enumeration Date | 2011-09-27 |
Last Update Date | 2023-06-26 |