| NPI | 1316513658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CT 136917) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: CT 136917) |
| 163WC1500X Registered Nurse, Community Health (Licence: CT 136917) | |
| 163WG0000X Registered Nurse, General Practice (Licence: CT 136917) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CT 136917) | |
| 163WR0400X Registered Nurse, Rehabilitation (Licence: CT 136917) | |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2021-05-27 |