NPI | 1922518836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN213368) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN213368) |
Enumeration Date | 2017-10-05 |
Last Update Date | 2023-04-21 |