| NPI | 1417434572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: WA AP60963397) |
| Additional Taxonomies | 163WN0800X Registered Nurse, Neuroscience (Licence: WA RN60448971) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP60963397) | |
| Enumeration Date | 2018-07-22 |
| Last Update Date | 2021-01-18 |