| NPI | 1447704796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: FL APRN9294865) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: FL 9294865) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL 9294865) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: FL 9294865) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9294865) | |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2022-12-29 |