| NPI | 1467844845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CO RN.1638316) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OR 201407085RN) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2018-03-30 |