| NPI | 1942073002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95296380) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN61393139) |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2025-05-26 |