NPI | 1821034182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP1946) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP1946) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2021-08-09 |