| NPI | 1932292695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: WA AP30005021) |
| Additional Taxonomies | 176B00000X Midwife (Licence: WA AP30005021) |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: WA AP30005021) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-08-08 |