| NPI | 1962180570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: CA 95111684) |
| Additional Taxonomies | 364SM0705X Clinical Nurse Specialist, Medical-Surgical (Licence: CA 95111684) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: CA 95111684) | |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-07-05 |