| NPI | 1760425466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007182) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA RN00145694) |
| 363L00000X Nurse Practitioner (Licence: WA AP30007182) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP30007182) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP30007182) | |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: WA AP30007182) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2025-01-28 |