| NPI | 1083321319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: OR 10047728) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 202215053RN) |
| 367A00000X Advanced Practice Midwife (Licence: WA ARNP.AP.70032957-CNM) | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2025-08-23 |