| NPI | 1528200847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 200842345RN) |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2010-11-15 |