| NPI | 1841421591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 163WI0600X Registered Nurse, Infection Control (Licence: WA RN00151248) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2022-05-12 |