| NPI | 1588389415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: MA RN2262047) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2262047) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2023-10-02 |