| NPI | 1740640143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: WA RN00113199) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00113199) |
| 163WA2000X Registered Nurse, Administrator (Licence: CA 459747) | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2020-11-05 |