NPI | 1245875947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95087065) |
Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 95087065) |
Enumeration Date | 2019-11-17 |
Last Update Date | 2023-01-24 |