| NPI | 1770926644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: CA 95163833) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60181322) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2018-06-21 |