NPI | 1548495047 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL ARNP1213622) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP1213622) |
Enumeration Date | 2009-05-28 |
Last Update Date | 2015-12-14 |