NPI | 1841368230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA NP5698) |
Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: CA 367611) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2021-11-18 |