NPI | 1841994043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023007559) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2014022773) |
Enumeration Date | 2023-03-30 |
Last Update Date | 2023-12-04 |