| NPI | 1831919695 |
|---|---|
| Professional Name | NA NA NA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: DC RN500003489) |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |