NPI | 1992011555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: PR 412) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PR 9536) |
Enumeration Date | 2010-08-20 |
Last Update Date | 2010-08-20 |