| NPI | 1891356671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 95020360) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: CA 95183228) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2022-10-10 |