| NPI | 1679469803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: WA RN61562421) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: WA RN61562421) |
| 163WG0000X Registered Nurse, General Practice (Licence: WA RN61562421) | |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-06-16 |