| NPI | 1366012791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA NP95017885) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020654) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA NP95017885) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NV 857119) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 243315) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 857119) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 243315) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11020654) | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2024-08-23 |