NPI | 1245698471 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202209936NP-PP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9345457) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9345457) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 6102) | |
Enumeration Date | 2016-02-02 |
Last Update Date | 2023-09-22 |