NPI | 1205523909 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN60866348) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95265500) |
Enumeration Date | 2023-04-21 |
Last Update Date | 2023-04-21 |