NPI | 1538668298 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9418311) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9418311) |
Enumeration Date | 2018-02-08 |
Last Update Date | 2022-02-15 |