NPI | 1407962038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: MA 124435) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MA 124435) |
Enumeration Date | 2006-08-23 |
Last Update Date | 2014-08-13 |