| NPI | 1861166415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95166664) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: CA 95166664) |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2021-08-06 |