| NPI | 1720073026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN00065178) |
| Additional Taxonomies | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2009-09-24 |