NPI | 1457957532 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WA AP61372812) |
Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: FL 9425118) |
363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL 11010486) | |
Enumeration Date | 2020-12-05 |
Last Update Date | 2022-12-02 |