| NPI | 1407983604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MA 168148) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: MA 168148) |
| 163WG0000X Registered Nurse, General Practice (Licence: MA 168148) | |
| 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: MA 168148) | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: MA 168148) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 168148) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |