| NPI | 1295243848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60909328) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 288853) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 862811) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN60641646) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95023203) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO C-APN.0103995-C-NP) | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2025-12-08 |