| NPI | 1184082489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA LW61259318) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WA SC60890351) |
| 133V00000X Dietitian, Registered (Licence: WA 86010670) | |
| 133V00000X Dietitian, Registered (Licence: WA DI60890355) | |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2022-12-15 |