| NPI | 1568848406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: WA RN60683138) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CO 0178155) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2019-05-09 |