| NPI | 1982180683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60957064) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: WA RN60957063) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: WA AP60957064) | |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2025-08-12 |