| NPI | 1457071672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ RN207238) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN207238) |
| 163W00000X Registered Nurse (Licence: CA RN95164545) | |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2024-03-22 |