NPI | 1356047088 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: DC NP1014616) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC RN1014616) |
Enumeration Date | 2023-02-03 |
Last Update Date | 2023-08-17 |