| NPI | 1275429953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: WA RN61577086) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA LP60858708) |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-06-17 |