| NPI | 1346557550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1032748) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2372566) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G168653) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61305143) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 278359) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10016393) | |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2024-02-11 |