NPI | 1144435025 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: HI APRN-271) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI 1217) |
Enumeration Date | 2007-05-13 |
Last Update Date | 2011-06-20 |