NPI | 1508826843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WA AP30006995) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30006995) |
Enumeration Date | 2006-03-23 |
Last Update Date | 2018-04-16 |