NPI | 1386653129 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP1266542) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL ARNP1266542) |
Enumeration Date | 2006-08-07 |
Last Update Date | 2022-11-15 |