| NPI | 1538814272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61641081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61016035) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN61016035) | |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2024-12-30 |