NPI | 1598916090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 00000) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 730858) |
164X00000X Licensed Vocational Nurse (Licence: CA VN195083) | |
Enumeration Date | 2008-10-02 |
Last Update Date | 2024-11-21 |