| NPI | 1306482831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61196426) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN.0998282-NP) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 163W00000X Registered Nurse (Licence: WA RN60793386) | |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2024-05-13 |