| NPI | 1629823869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: WA RN61418396) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61418396) |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2025-08-17 |