| NPI | 1538709738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202001770NP-PP) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN61052586) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 202001267RN) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61052588) | |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2022-12-19 |