NPI | 1942730783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95162669) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2017-06-14 |
Last Update Date | 2022-07-21 |