NPI | 1184371338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 14184137-4405) |
Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: UT 11647011-3102) |
Enumeration Date | 2022-03-08 |
Last Update Date | 2024-09-24 |