| NPI | 1851346654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: IL 277000284) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.000284) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: IL 277000284) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2022-01-25 |