| NPI | 1689823551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: WA RN00143594) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA RN00143594) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2009-04-08 |