NPI | 1821444993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 201404699RN) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2016-05-09 |
Last Update Date | 2016-06-10 |