| NPI | 1477238004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 13394048-4405) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 74390) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406278) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10004815) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95026404) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 295525) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0010673) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO C-RXN-0102363) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: HI 4145) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 76812) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G175279) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-82495-102) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4027340) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 217178) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 869882) | |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2025-08-21 |