NPI | 1093107732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015577) |
Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: CA 95015577) |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA RN827983) | |
Enumeration Date | 2015-03-03 |
Last Update Date | 2023-05-08 |