NPI | 1265858666 |
---|---|
Other Name | HERMAN JEROME SCHANNAULT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP2632452) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP2632452) |
Enumeration Date | 2014-03-10 |
Last Update Date | 2014-03-17 |