| NPI | 1598858292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MI 4704170054) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704170054) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-12-15 |