NPI | 1992327738 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 71968) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 146643) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 5379777022) | |
Enumeration Date | 2020-05-14 |
Last Update Date | 2023-02-10 |