| NPI | 1801632088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95326974) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: CA 95326974) |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-08-22 |