| NPI | 1326474685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002252) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NV RN61345) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NV APRN002252) | |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2022-11-02 |