| NPI | 1134769029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: NV RN60918) |
| Additional Taxonomies | 163WR0400X Registered Nurse Rehabilitation (Licence: NV RN60918) |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-09 |