| NPI | 1427876382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 728594) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: NY 728594) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: NY 728594) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NY 728594) | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |