| NPI | 1699512897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2009007218) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MO 2009007218) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2025-07-17 |