NPI | 1891082376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: HI APRN-2714) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-2714) |
Enumeration Date | 2011-07-05 |
Last Update Date | 2023-05-18 |