NPI | 1376250548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: NC 313410) |
Additional Taxonomies | 106S00000X Behavior Technician |
174H00000X Health Educator | |
Enumeration Date | 2022-10-27 |
Last Update Date | 2022-10-27 |