NPI | 1922454651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: TX 1012663) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
363L00000X Nurse Practitioner (Licence: TX 1012663) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1012663) | |
364S00000X Clinical Nurse Specialist (Licence: TX 1012663) | |
Enumeration Date | 2016-05-12 |
Last Update Date | 2025-08-20 |