NPI | 1740865575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AR R092352) |
Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: AR R092352) |
163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: AR R092352) | |
Enumeration Date | 2021-03-12 |
Last Update Date | 2021-03-12 |