| NPI | 1033465430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: TN 175440) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: TN 31115) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2012-08-03 |