| NPI | 1881736338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA NP95007718) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MA RN230451) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN230451) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2023-09-26 |