NPI | 1639933567 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OK 217068) |
Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: OK R0106739) |
Enumeration Date | 2024-02-12 |
Last Update Date | 2024-02-28 |