| NPI | 1366886079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL RN9195067) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL RN9195067) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: FL RN9195067) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: FL RN9195067) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |