| NPI | 1134990583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OH RN.412901) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IN RN28220588A) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL RN9591819) | |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |