| NPI | 1588358147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 36622) |
| Additional Taxonomies | 247000000X Technician, Health Information |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-08 |