| NPI | 1801587449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 842761) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 546175) |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-06-22 |