NPI | 1700652369 |
---|---|
Former Name | RANDALL DUKE OLO LEALOFI SAFOTU |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA RN95336194) |
Enumeration Date | 2023-11-27 |
Last Update Date | 2023-11-27 |