NPI | 1528487121 |
---|---|
Former Name | BRADLEY JOHN KANE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: HI 1741) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI 1741) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2022-07-21 |