NPI | 1528514296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN61695) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC 61695) |
Enumeration Date | 2016-08-31 |
Last Update Date | 2023-05-22 |