| NPI | 1417220419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: NH 027381-21) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NH 027381-21) |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2012-02-22 |