NPI | 1710434493 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60938185) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60456647) |
363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP60938185) | |
Enumeration Date | 2016-09-09 |
Last Update Date | 2022-01-31 |