| NPI | 1578014668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NH 074625-21) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 074625-23) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2025-03-06 |