| NPI | 1750073920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP70059288) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA ARNP.AP.70059288-NP) |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2026-01-28 |