| NPI | 1356830384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA NP95009654) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: LA RN140980) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: LA AP10024) | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-09-08 |