| NPI | 1932415288 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 200740319RN) | 
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: OR 200740319RN) | 
| 163WH1000X Registered Nurse, Hospice (Licence: OR 200740319RN) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN00170309) | |
| Enumeration Date | 2010-08-25 | 
| Last Update Date | 2015-01-08 |