| NPI | 1952279317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN60431595) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: WA LR60431161) |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |