| NPI | 1609942663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse Case Management (Licence: TN RN0000119236) |
| Additional Taxonomies | 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent (Licence: TN RN0000119236) |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: TN RN0000119236) | |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: TN RN0000119236) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |