| NPI | 1467239210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 555854) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: NY 555854) |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |