NPI | 1811435043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201392609) |
Enumeration Date | 2017-02-08 |
Last Update Date | 2020-06-16 |