| NPI | 1467430512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364S00000X Clinical Nurse Specialist (Licence: RI APRN00041) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: RI PPNS00070) |
| Enumeration Date | 2006-01-07 |
| Last Update Date | 2018-07-18 |