| NPI | 1689426074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95366539) |
| Additional Taxonomies | 163WP1700X Registered Nurse, Perinatal (Licence: CA 95366539) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |