NPI | 1770283921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ 286130) |
Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX 1112295) |
363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NM 73419) | |
Enumeration Date | 2023-03-07 |
Last Update Date | 2023-10-11 |