| NPI | 1073446449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95363568) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 95363568) |
| Enumeration Date | 2026-06-05 |
| Last Update Date | 2026-06-05 |