| NPI | 1366560047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 698617) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 698617) |
| 171M00000X Case Manager/Care Coordinator | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2014-01-06 |