| NPI | 1518469196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse Medical-Surgical (Licence: WA RN60803029) |
| Additional Taxonomies | 163WG0600X Registered Nurse Gerontology (Licence: WA RN60803029) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |