| NPI | 1679576672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30006338) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: WA AP30006338RN00135307) |
| 163WA2000X Registered Nurse, Administrator (Licence: WA AP30006338RN00135307) | |
| 163W00000X Registered Nurse (Licence: WA AP30006338RN00135307) | |
| 163WC0400X Registered Nurse, Case Management (Licence: WA AP30006338RN00135307) | |
| 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: WA AP30006338RN00135307) | |
| 163WN0800X Registered Nurse, Neuroscience (Licence: WA AP30006338RN00135307) | |
| 163WP0000X Registered Nurse, Pain Management (Licence: WA AP30006338RN00135307) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: WA AP30006338RN00135307) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2023-03-07 |