NPI | 1144714304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CA 1144714304) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OH RN.488666) |
Enumeration Date | 2018-06-20 |
Last Update Date | 2024-05-15 |