| NPI | 1457969545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: RI RN66800) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN66800) |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2025-05-27 |