| NPI | 1548018146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: NY 746545) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 746545) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 746545) | |
| 163WS0200X Registered Nurse, School (Licence: NY 746545) | |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-05-08 |