| NPI | 1548275274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TN 6820) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: TN APN0000006820) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-01-02 |