NPI | 1407844988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP1682212) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP1682212) |
Enumeration Date | 2005-10-10 |
Last Update Date | 2019-06-04 |