NPI | 1336730084 |
---|---|
Former Name | TODD RYAN INFINGER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024182774) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11011297) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 29138) | |
Enumeration Date | 2021-01-26 |
Last Update Date | 2025-02-27 |