| NPI | 1558085076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WI0500X Registered Nurse, Infusion Therapy (Licence: WA RN61053428) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: WA 61053428) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-09-28 |