NPI | 1730262528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 505907) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 505907) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2025-03-27 |