NPI | 1710623657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 95281724) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 95281724) |
163WM0705X Registered Nurse, Medical-Surgical (Licence: AZ 245932) | |
Enumeration Date | 2022-05-11 |
Last Update Date | 2022-05-17 |