| NPI | 1831345990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA RN215489) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 215489) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2015-09-24 |