| NPI | 1952545048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61168278) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH60624911) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2023-11-09 |