| NPI | 1407964638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: CA 0240982) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN95044800) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA PMH586) | |
| 364S00000X Clinical Nurse Specialist (Licence: CA CNS4252) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2019-06-12 |