| NPI | 1851977706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61505604) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: WA RN60946240) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN60946240) | |
| 363L00000X Nurse Practitioner (Licence: WA AP61505604) | |
| 163WC0400X Registered Nurse, Case Management (Licence: WA RN60946240) | |
| 163WA2000X Registered Nurse, Administrator (Licence: WA RN60946240) | |
| 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: WA RN60946240) | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2024-03-23 |