| NPI | 1851838536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL ARNP9180838) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: FL ARNP 9180838) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2022-07-06 |