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 |