| NPI | 1184310492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: CA 788882) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CA 788882) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-04-11 |