| NPI | 1124726690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: GA RN305827) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: GA RN305827) |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2025-08-22 |