NPI | 1982466371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR 120393) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AR 120393) |
Enumeration Date | 2024-01-30 |
Last Update Date | 2025-08-28 |