NPI | 1376038943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 848893) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 848893) |
163WA2000X Registered Nurse, Administrator (Licence: CA 848893) | |
Enumeration Date | 2018-06-26 |
Last Update Date | 2018-06-26 |