NPI | 1962265744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 200841670RN) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60283278) |
Enumeration Date | 2024-02-05 |
Last Update Date | 2024-02-05 |