NPI | 1073877155 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60292813) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00174999) |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN00174999) | |
363LF0000X Nurse Practitioner, Family (Licence: WA AP60292813) | |
363LF0000X Nurse Practitioner, Family (Licence: ID 25237) | |
Enumeration Date | 2012-07-03 |
Last Update Date | 2023-12-21 |