NPI | 1184468118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 80010) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME CNP241300) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ RNP312924) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61579845) | |
Enumeration Date | 2024-06-24 |
Last Update Date | 2024-08-23 |