| NPI | 1053759217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 726417) |
| Additional Taxonomies | 163WA2000X Registered Nurse Administrator (Licence: CA 726417) |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: CA 726417) | |
| 163WC0400X Registered Nurse Case Management (Licence: CA 726417) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 726417) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA NP95023143) | |
| 2083A0300X Preventive Medicine Addiction Medicine (Licence: AZ 279741) | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: AZ 279741) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ 279741) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ NP279741) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NM 70411) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR 10031832) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WA AP61372139) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX 1098621) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NP95023143) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2024-10-05 |