| NPI | 1831500388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61074114) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60200258) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN60200258) | |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2024-05-30 |