| NPI | 1689083230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP 9266179) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9266179) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 53779) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2349904) | |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9266179) | |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2024-01-15 |