NPI | 1730614579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN61217405) |
Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: WA PC60752642) |
Enumeration Date | 2017-05-01 |
Last Update Date | 2024-02-10 |