NPI | 1932887338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11027323) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL APRN11027323) |
364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: FL APRN11027323) | |
Enumeration Date | 2023-07-06 |
Last Update Date | 2024-05-07 |