| NPI | 1912108648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: CO 0996112) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MN R1612293) |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MN R161229-3) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2022-05-13 |