| NPI | 1326535683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NV APRN002821) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002821) |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2021-03-29 |