NPI | 1861944993 |
---|---|
Professional Name | NONE NONE NONE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP132370) |
Enumeration Date | 2016-10-24 |
Last Update Date | 2016-10-24 |