| NPI | 1487383253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 95166577) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95166577) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-07 |