| NPI | 1699150185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: TN 20189) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 20189) |
| Enumeration Date | 2015-07-25 |
| Last Update Date | 2016-05-19 |