| NPI | 1629619358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP142735) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX AP142735) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX AP142735) | |
| 101YM0800X Counselor, Mental Health (Licence: TX AP142735) | |
| 101YP2500X Counselor, Professional (Licence: TX AP142735) | |
| 163WC0400X Registered Nurse, Case Management (Licence: TX 773383) | |
| 163WH1000X Registered Nurse, Hospice (Licence: TX 773383) | |
| 171M00000X Case Manager/Care Coordinator (Licence: TX 773383) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: TX 773383) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX 773383) | |
| 2084H0002X (Licence: TX AP142735) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX AP142735) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX AP142735) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TX AP142735) | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-12-23 |