NPI | 1669959359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28180366A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71008320A) |
Enumeration Date | 2018-07-25 |
Last Update Date | 2025-09-29 |