| NPI | 1417205527 |
|---|---|
| Former Name | BRIAN JAMES NAKKERUD-WHITESIDE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 23511) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 802020) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 87055) | |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2017-05-11 |