NPI | 1285249540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1046850) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95032555) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61187130) | |
163WE0003X Registered Nurse, Emergency (Licence: TX 942541) | |
363LF0000X Nurse Practitioner, Family (Licence: WA AP61187130) | |
363LF0000X Nurse Practitioner, Family (Licence: DE LG-0011717) | |
363LF0000X Nurse Practitioner, Family (Licence: TX 1046850) | |
Enumeration Date | 2020-09-14 |
Last Update Date | 2025-09-07 |