| NPI | 1275939068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: RI APRN00004) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: RI APRN00004) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2020-09-16 |