NPI | 1942343256 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 0017140528) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 0015000634) |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 0024169909) | |
Enumeration Date | 2007-02-15 |
Last Update Date | 2014-04-18 |