| NPI | 1689991887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ RN077937) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN077937) |
| 163WA2000X Registered Nurse, Administrator (Licence: AZ RN077937) | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2024-01-15 |