| NPI | 1053178988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95347407) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CA 95347407) |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 95347407) | |
| 163W00000X Registered Nurse (Licence: CA 95347407) | |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |