| NPI | 1154588119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 4720618) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 130599-30) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2023-01-13 |