| NPI | 1427092683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200950024NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00156444) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007167) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-11-09 |