| NPI | 1457559965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: CA 375170) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-07-21 |