| NPI | 1023500386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN00145870) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: WA RN00145870) |
| Enumeration Date | 2018-06-03 |
| Last Update Date | 2018-06-03 |