| NPI | 1164831368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA RN95143251) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CA RN95143251) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA RN95143251) | |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2023-07-11 |