| NPI | 1326515990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95027621) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 95128545) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95128545) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 95128545) | |
| 363L00000X Nurse Practitioner (Licence: CA 95027621) | |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2024-03-08 |