NPI | 1831286731 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MN R178506-5) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TX 723743) |
364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: TX 723743) | |
Enumeration Date | 2006-10-10 |
Last Update Date | 2012-06-14 |