NPI | 1750575338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: SC 4291) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: SC R38298) |
Enumeration Date | 2007-08-28 |
Last Update Date | 2011-09-15 |