| NPI | 1407687486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: KY 1152999) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |