| NPI | 1851507602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CA 530763) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 530763) |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 530763) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |