| NPI | 1689322398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61386157) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: WA RN60659272) |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2024-03-11 |