NPI | 1487001798 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN202887) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN202887) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN202887) | |
Enumeration Date | 2016-05-17 |
Last Update Date | 2024-09-10 |