NPI | 1427754191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61406192) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 8045752-4405) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10016581) | |
Enumeration Date | 2023-02-03 |
Last Update Date | 2024-08-15 |