| NPI | 1730244534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: WA RN00133491) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: OR 098000714RN) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2007-07-08 |