| NPI | 1366852394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: WA RN00154259WA) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00003042WA) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2014-04-29 |