NPI | 1881320414 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 278357) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN211986) |
Enumeration Date | 2022-07-26 |
Last Update Date | 2022-10-12 |