| NPI | 1265545685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: AZ RN063569) |
| Additional Taxonomies | 163WI0600X Registered Nurse, Infection Control (Licence: AZ RN063569) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: AZ RN063569) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: AZ RN063569) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |