| NPI | 1225165822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 19967) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS 21935) |
| 163WC1500X Registered Nurse, Community Health (Licence: CA 74036) | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CA 732493) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 732493) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 19967) | |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: CA 3515) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-03-06 |