NPI | 1922431063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA 260469) |
Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: MA 260469) |
Enumeration Date | 2013-08-13 |
Last Update Date | 2013-09-30 |