NPI | 1558816306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 8099) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ND R38492) |
363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 295229) | |
363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: ND R38492) | |
Enumeration Date | 2016-08-22 |
Last Update Date | 2023-07-18 |