| NPI | 1952815532 | 
|---|---|
| Professional Name | SHANE MARTIN | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201810779RN) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OK 116346) | 
| Enumeration Date | 2017-11-19 | 
| Last Update Date | 2019-07-05 |