| NPI | 1881328912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: PR 2955) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PR 73442G) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-08-04 |