| NPI | 1386122893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 653783) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 653783) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2019-04-12 |