NPI | 1396855409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OK R 0024189) |
Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: AK 12898) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-07-08 |