NPI | 1932241007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NV APRN000902) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NV APRN000902) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2017-09-26 |