| NPI | 1578986873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: MI 4704193600) |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management (Licence: MI 4704193600) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |