| NPI | 1538510342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CO RN.1640336) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1640336) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2023-05-18 |