| NPI | 1982362182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA GAA-NP001562) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: SC 231339) |
| Enumeration Date | 2021-12-04 |
| Last Update Date | 2023-11-27 |