| NPI | 1851266654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WA RN61557430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP.70058866-NP) |
| Enumeration Date | 2025-10-09 |
| Last Update Date | 2025-10-22 |