| NPI | 1588375307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN1016058) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: DC RN1016058) |
| 251S00000X | |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2024-02-28 |