| NPI | 1194178780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: WA PC60777046) |
| Additional Taxonomies | 172A00000X Driver (Licence: WA WDL77143J53B) |
| 106S00000X Behavior Technician | |
| 374U00000X Home Health Aide | |
| 207Q00000X Family Medicine (Licence: WA 1194178780) | |
| 291U00000X Clinical Medical Laboratory (Licence: WA 1831957026) | |
| 251J00000X Nursing Care (Licence: NM NM0049261107E) | |
| 247200000X Technician, Other (Licence: WA MR60846454) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2026-04-14 |