| NPI | 1295414514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 877464) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV RN93749) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2024-07-06 |