| NPI | 1053944108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WA AP61288343) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: WA RN60791598) |
| 363LA2100X Nurse Practitioner Acute Care (Licence: WA AP61288343) | |
| 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: WA AP61288343) | |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2024-02-19 |