| NPI | 1073394920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WN0800X Registered Nurse, Neuroscience (Licence: MI 4704253423) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: MI 1601344) |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2023-10-06 |