NPI | 1447743117 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60825331) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60825331) |
Enumeration Date | 2018-06-07 |
Last Update Date | 2023-09-21 |