NPI | 1740549799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: LA AP06883) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: LA AP06833) |
Enumeration Date | 2012-05-11 |
Last Update Date | 2018-10-12 |