| NPI | 1902529498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IN 28234650A) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: IN 2020130842) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: IN 2020130842) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IN 2020130842) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: IN 2020130842) | |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-09-21 |