| NPI | 1083582647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: OK 52998) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OK R0114576) |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |