| NPI | 1518135268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: FL 0935042) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: FL 0935042) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-02-15 |