| NPI | 1447672134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 201501939NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 815116) |
| 363L00000X Nurse Practitioner (Licence: WA AP60565022) | |
| 163W00000X Registered Nurse (Licence: OR 201501933RN) | |
| 163W00000X Registered Nurse (Licence: WA RN60553698) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95000311) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201501939NP-PP) | |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2022-05-06 |