| NPI | 1790549848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN61026231) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: WA RN61026231) |
| 163WH1000X Registered Nurse, Hospice (Licence: WA RN61026231) | |
| Enumeration Date | 2024-02-09 |
| Last Update Date | 2024-02-09 |