| NPI | 1750182051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: GA RN298354) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: GA RN298354) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: GA RN298354) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: GA RN298354) | |
| Enumeration Date | 2025-03-22 |
| Last Update Date | 2025-03-22 |