| NPI | 1447287628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health (Licence: TN 8482) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TN APN 8482) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-03-09 |