NPI | 1861278442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: FL APRN11028488) |
Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: FL APRN11028488) |
163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: FL APRN11028488) | |
Enumeration Date | 2023-09-07 |
Last Update Date | 2023-09-20 |