| NPI | 1558059253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WA RN61294879) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61294879) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2024-10-17 |