| NPI | 1992156111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NH 070741-21) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NH 070741-21) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2019-09-30 |