| NPI | 1598209991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO C-APN.0103098-C-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH CNP.020281) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009113) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 81063) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11009113) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10032930) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61615798) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 229865) | |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2025-01-03 |