| NPI | 1750182051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA NP298354) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: GA RN298354) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: GA RN298354) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA NP298354) | |
| Enumeration Date | 2025-03-22 |
| Last Update Date | 2026-03-20 |