NPI | 1346496767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 22192) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 695830) |
163WC1500X Registered Nurse Community Health (Licence: CA 73737) | |
Enumeration Date | 2008-08-18 |
Last Update Date | 2014-07-21 |