| NPI | 1457301491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: WA AP60426528) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 200350053NP PMHNP-PP) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2015-02-24 |