| NPI | 1811708761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1083779) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10058155) |
| 163W00000X Registered Nurse (Licence: HI 1295460) | |
| 163W00000X Registered Nurse (Licence: AK 252454) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: HI 58310) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 89175) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 70107483) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11046516) | |
| 163W00000X Registered Nurse (Licence: OR 10058155) | |
| 163W00000X Registered Nurse (Licence: TX 1083779) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 337993) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 252455) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 0106331) | |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2026-06-23 |