| NPI | 1356199913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA ARNP.AP.70035123-NP) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA ARNP.AP.70035123-NP) |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2026-07-21 |