| NPI | 1275041477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202112981NP-PP) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0134731) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61136881) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 084400-23) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2323354) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME CNP211039) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP019201) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DC RN1061501) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403863-01) | |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2023-12-25 |