NPI | 1609597392 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 857971) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 857971) |
Enumeration Date | 2022-09-09 |
Last Update Date | 2023-06-07 |