NPI | 1417737396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71014458A) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IN 28248377A) |
Enumeration Date | 2023-09-29 |
Last Update Date | 2024-05-15 |