| NPI | 1134944499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 955394-01) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 955394-01) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |