| NPI | 1154899805 |
|---|---|
| Former Name | AUDREY CAVINS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61025837) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3012865) |
| Enumeration Date | 2018-11-10 |
| Last Update Date | 2024-04-19 |