| NPI | 1922695501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5013930) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO C-APN.0003017-C-NP) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61149987) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12.010267) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 66326) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 67575) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403974) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 843030) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019014) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024182451) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11012041) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1032559) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G162697) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202111691NP-PP) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 255905) | |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2025-12-09 |