| NPI | 1477385664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95387982) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60363350) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |