| NPI | 1760733273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 821565) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 821565) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2015-10-09 |