NPI | 1538896410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 13051-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 252125-30) |
Enumeration Date | 2022-08-02 |
Last Update Date | 2023-09-27 |