NPI | 1740446335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202114724NP-PP) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 202114724NP-PP) |
Enumeration Date | 2008-08-02 |
Last Update Date | 2025-10-01 |