| 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 |