| NPI | 1841825973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: HI APRN-5266-0) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI Rn-95366) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2025-06-12 |