| NPI | 1841762762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5014284) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ND R49981) |
| 163W00000X Registered Nurse (Licence: AZ RN182078) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403915) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71015544A) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 181097) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 224121) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR 230693) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME CNP211665) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 0037083) | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2025-02-12 |