| NPI | 1780956375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: PR 2168E) |
| Additional Taxonomies | 163WI0600X Registered Nurse, Infection Control (Licence: PR 2168E) |
| 163W00000X Registered Nurse (Licence: PR 32920) | |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2024-01-18 |