| NPI | 1497823652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: CO 80032CNS) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CO APN.0002986-CNS) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2022-06-24 |