| NPI | 1225460876 |
|---|---|
| Former Name | PETER MAGANA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 53-76082-061) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CO APN-0992322-NP) |
| 163W00000X Registered Nurse (Licence: KS 14116581061) | |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2021-07-19 |