NPI | 1841797842 |
---|---|
Other Name | IAN DOMINGO VICTORIO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9415884) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9415884) |
Enumeration Date | 2018-04-07 |
Last Update Date | 2024-10-24 |