| NPI | 1437475753 |
|---|---|
| Former Name | MICHAEL BEATTY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP246670) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN.135636-M-IV) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 0027525) | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2021-01-08 |