NPI | 1396247359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9326452) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9326452) |
364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: FL ARNP9326452) | |
Enumeration Date | 2018-03-06 |
Last Update Date | 2018-10-08 |